Validation of the QuickDASH and DASH in Patients with Distal Radius Fractures through Agreement Analysis

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Philemon Tsang, David Walton, Ruby Grewal, Joy MacDermid
ObjectiveTo examine the agreement of scores between the Disability of Arm, Shoulder and Hand (DASH) and QuickDASH Questionnaires in patients with distal radius fractures (DRF) and their score's concurrent validity with PRWE scores.DesignValidity StudySettingHand and upper limb clinicParticipantsOne hundred and seventy-seven patients with Distal Radius Fractures over the age of 18 were included in this study.InterventionsN/AMain Outcome MeasuresMeasurements of the DASH, QuickDASH, and Patient Reported Wrist Evaluation (PRWE) were taken at baseline and 1-year follow-up. QuickDASH scores were extracted from the DASH scores. Agreement analysis of the DASH and QuickDASH were evaluated using Bland-Altman's technique. Item difficultly analysis was performed to examine the distribution of QuickDASH items amongst DASH items. Responsiveness of the DASH, QuickDASH, and PRWE were also evaluated by calculating standardized response means.ResultsQuickDASH scores were higher than DASH scores, particularly at baseline. A mean difference of 3.8 and 1.2 points were observed at baseline and 1-year follow-up, respectively. The limits of agreement (LOA) were wide at baseline with a range of 24.8 points at baseline, but decreased to 12.5 points at 1-year follow-up. Item difficulty analysis revealed that QuickDASH items were not evenly distributed at baseline. Finally, the responsiveness of the DASH, QuickDASH and PRWE were similar from baseline to 1-year follow-up (standardized response mean of 2.13, 2.17, and 2.19, respectively).ConclusionWhen changing from the DASH to the QuickDASH in the context of DRF, a systematic bias of higher scores on the QuickDASH should be considered by the user. However, the QuickDASH still demonstrated good concurrent validity and responsiveness.



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